Complaints of insomnia among midlife employed people: The contribution of childhood and present socioeconomic circumstances

BackgroundStudies using conventional socioeconomic indicators have reported inconsistent evidence on socioeconomic differences in complaints of insomnia. We lack studies using a comprehensive socioeconomic framework over the life course ranging from childhood to adulthood. This study therefore aimed to examine the associations of both past and present socioeconomic circumstances with complaints of insomnia.MethodsData were derived from cross-sectional postal surveys (2000–2002) representative of the staff of the City of Helsinki, Finland (n = 8960, aged 40–60 years). Socioeconomic circumstances were measured by parental education, childhood economic difficulties, own education, occupational class, household income, housing tenure, and current economic difficulties. Complaints of insomnia during the previous month were measured by difficulties initiating and maintaining sleep and non-restorative sleep. Logistic regression analysis was used, adjusting for age and marital status.ResultsComplaints of insomnia at least once a week were reported by 25% of women and 21% of men. Childhood economic difficulties showed associations with complaints of insomnia among both women (OR 1.52; 95% CI 1.31–1.76) and men (OR 2.25; 95% CI 1.67–3.02) even after full adjustments. Also current economic difficulties remained associated with complaints of insomnia, but only among women (OR 1.65; 95% CI 1.41–1.93). However, education, occupational class, and income showed only limited age-adjusted associations with complaints of insomnia and these associations disappeared after full adjustments.DiscussionPast and present economic difficulties were strongly associated with current complaints of insomnia. Supporting both families with children and adults to cope with their economic difficulties might reduce complaints of insomnia in adulthood.     

Antifungal resistance in Candida spp. isolated in Italy between 2002 and 2005 from children and adults

The activity of amphotericin B, fluconazole, flucytosine, itraconazole and voriconazole was tested in vitro against 618 clinical Candida spp. isolates, using the broth microdilution or the disk diffusion method (voriconazole). Amphotericin B and voriconazole were the most potent antifungal agents assayed (100% of susceptible strains). Resistance to fluconazole and itraconazole was detected in three (0.7%) and 11 (2.7%) isolates of Candida albicans and in four (3.7%) isolates of Candida glabrata. Flucytosine intermediate, resistant strains, or both, were observed in C. albicans (0.3% and 0.7%), C. glabrata (2.8% intermediate) and C. tropicalis (15.2% and 15.2%). C. krusei was the least susceptible species to azoles. No statistically significant differences in the rates of resistant isolates depending on site of infection and age of the patient were observed, with the exception of C. albicans and itraconazole (higher percentage of resistance in children). At present, acquired antifungal resistance represents an uncommon finding in most Candida spp. circulating in Northern Italy.     

Comparison of pentamidine isethionate and trimethoprim-sulfamethoxazole in the treatment of Pneumocystis carinii pneumonia.

Fifty patients with P. carinii pneumonitis were randomized to receive either pentamidine isethionate or trimethoprim-sulfamethoxazole therapy. Those not responding favorably to the first drug after three or more days of therapy were changed to the alternate drug. Of the 26 patients initially treated with TMP-SMZ, 20 recovered (0.77)-17 after TMP-SMZ alone and three of nine who were crossed over to pentamidine. Of the 24 patients initially treated with pentamidine, 18 recovered (0.75)-14 of 15 who received only pentamidine and four of nine who were crossed over to TMP-SMZ. Abnormal values for blood urea nitrogen, creatinine, or glucose; inflammation at injection sites; or combination of these effects occurred in 14 of the 15 patients treated with pentamidine alone. Only one of the 17 patients treated with TMP-SMZ alone developed any of these abnormalities. This study shows that TMP-SMZ is as effective as pentamidine in the treatment of PCP, and that it offers the advantages of minimal adverse effects, oral administration, and ready availability.     

Delirium in elderly people without severe predisposing disorders: etiology and 1-year prognosis after discharge

BACKGROUND: The etiologic factors of delirium have been frequently studied in hospitalized elderly patients who usually have an underlying disorder, i.e., hip fracture or dementia predisposing to delirium. The etiologic factors of delirium and prognosis in healthy elderly remain unstudied. The aim of our study was to detect the primary and additional etiologic factors contributing to delirium among community-dwelling healthy elderly people without predisposing disorders to delirium and to evaluate 1-year prognosis after discharge to home. METHOD: The study subjects consisted of 51 community-dwelling people over 65 years of age, without severe underlying disorders predisposing to delirium, admitted consecutively to the hospital because of a delirious state. The diagnosis of delirium was based on the DSM-III-R criteria. After discharge to home, the subjects were followed up for 1 year. RESULTS: The most important primary causes of delirium were infections in 22 cases (43%) and cerebrovascular attacks in 13 cases (25%). After the 1-year follow-up period, 10 patients (20%) had been taken into long-term care and 5 patients (10%) had died. DISCUSSION: The plausible etiologic factor of delirium was detected in all cases. Among healthy elderly people, infections and cerebrovascular attacks were the most important etiologic factors for delirium. After discharge to home, 30% of the patients had to be taken into long-term care or had died within 1 year of the delirium.     

Separation of A- and B-type Glycopeptides of Semliki forest virus by concanavalin A affinity chromatography and preliminary characterization of the B-type glycopeptides

A- and B-type glycopeptides of Semliki forest virus were separated by affinity chromatography on concanavalin A (Con A)-Sepharose. The A-type glycopeptides were identified by their high galactose content and the B-type glycopeptides, by their reactivity with α-mannosidase and endo-β-N-acetylglucosaminidase H. The purity and the nature of the separated glycopeptides can also be established by gel filtration because the viral A- and B-type glycopeptides are of different size. The degradative experiments suggested that the glycans of the B-type glycopeptides contained, on the average, four to six distally located α-mannose residues, probably one centrally located β-mannose residue, and two vicinal N-acetylglucosamine residues close to the peptide part of the molecule.     

Kynurenine may directly interact with GABA receptors in rat brain

Previous studies have shown that kynurenine may have convulsant activity. In the present investigation the intracerebroventricular injection of L- but not D-kynurenine induced convulsions in the rat. In vitro, L- but not D-kynurenine was able to displace 3H-GABA from rat brain membrane preparations. The action was specific for 3H-GABA and was not observed with other ligands. The data suggest that the convulsant activity of L-kynurenine might be due to an interaction with GABA receptors.